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经皮电刺激神经疗法(TENS)对双侧保留神经机器人辅助根治性前列腺切除术后勃起功能障碍的康复作用

Transcutaneous electrical nerve stimulation (TENS) therapy in rehabilitating erectile dysfunction after bilateral nerve sparing robotic assisted radical prostatectomy.

作者信息

Suçeken Ferhat Yakup, Coşer Şeref, Kurtuluş Duygu, Akgül Murat, Kül Kamil, Sevim Mehmet, Ekşi Mithat, Küçük Eyüp Veli, Aras Bekir

机构信息

Umraniye Training & Research Hospital, Department of Urology, Health Sciences University, İstanbul, Turkey.

Department of Urology, Kutahya Health Science University, Kutahya, Turkey.

出版信息

World J Urol. 2025 May 29;43(1):337. doi: 10.1007/s00345-025-05707-0.

Abstract

AIM

Erectile dysfunction (ED) represents one of the most clinically significant and detrimental quality-of-life complications in prostate cancer (PCa) patients following treatment. Different modalities are applied to improve and rehabilitate functional results, especially erectile function after radical prostatectomy (RP). We aimed to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) on postoperative erectile function in patients who underwent bilateral nerve sparing robot-assisted radical prostatectomy (RARP).

METHODS

The data of patients who underwent RARP for PCa were retrospectively examined. Patients were divided into two groups: those who underwent TENS to improve ED status after RARP (TENS(+)) and those who did not (TENS(-)). The patients' demographic data, surgical data, pre-op/post-op 3rd month International Prostate Symptom Score (IPSS), and pre-op/post-op 6th and 12th month International Index of Erectile Function (IIEF-5) data were evaluated.

RESULTS

Of the 80 patients included in the study, 40 were allocated to the TENS(+) group and 40 to the TENS(-) group. The demographic and operative characteristics of the groups were similar. Preoperative and postoperative IPSS were statistically similar in both groups (p = 0.07 and p = 0.12, respectively). While, the mean preoperative IIEF-5 scores were similar for two groups, they were found to be statistically higher in the TENS(+) group in post-operative 6th months (p < 0.001). However, the improvement in IIEF score in the TENS(-) group was more pronounced during the second six months post-operatively, and no statistically significant difference was observed between the two groups at the 12th postoperative month (p = 0.12).

CONCLUSION

TENS therapy administered following RARP may be efficacious in penile rehabilitation 6 months post-surgery. TENS may be an alternative therapy for patients seeking early erectile recovery after RARP.

摘要

目的

勃起功能障碍(ED)是前列腺癌(PCa)患者治疗后临床上最显著且对生活质量有损害的并发症之一。人们采用了不同的方法来改善和恢复功能结果,尤其是根治性前列腺切除术(RP)后的勃起功能。我们旨在评估经皮电刺激神经疗法(TENS)对接受双侧神经保留机器人辅助根治性前列腺切除术(RARP)患者术后勃起功能的影响。

方法

对因PCa接受RARP治疗的患者数据进行回顾性分析。患者分为两组:RARP术后接受TENS以改善ED状况的患者(TENS(+)组)和未接受TENS的患者(TENS(-)组)。评估患者的人口统计学数据、手术数据、术前/术后第3个月的国际前列腺症状评分(IPSS)以及术前/术后第6个月和第12个月的国际勃起功能指数(IIEF-5)数据。

结果

该研究纳入的80例患者中,40例被分配至TENS(+)组,40例被分配至TENS(-)组。两组的人口统计学和手术特征相似。两组术前和术后的IPSS在统计学上相似(分别为p = 0.07和p = 0.12)。虽然两组术前IIEF-5评分均值相似,但术后第6个月TENS(+)组的评分在统计学上更高(p < 0.001)。然而,TENS(-)组在术后第二个六个月期间IIEF评分的改善更为明显,术后第12个月两组之间未观察到统计学上的显著差异(p = 0.12)。

结论

RARP术后进行TENS治疗可能在术后6个月对阴茎康复有效。TENS可能是RARP后寻求早期勃起功能恢复患者的一种替代治疗方法。

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